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绝经前和围绝经期女性高血压的种族差异:全国女性健康研究

Ethnic variation in hypertension among premenopausal and perimenopausal women: Study of Women's Health Across the Nation.

作者信息

Lloyd-Jones Donald M, Sutton-Tyrrell Kim, Patel Ami S, Matthews Karen A, Pasternak Richard C, Everson-Rose Susan A, Scuteri Angelo, Chae Claudia U

机构信息

Division of Cardiology, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.

出版信息

Hypertension. 2005 Oct;46(4):689-95. doi: 10.1161/01.HYP.0000182659.03194.db. Epub 2005 Sep 6.

Abstract

Data are sparse regarding hypertension prevalence, treatment, and control among some ethnic groups of American women. Furthermore, the effects of ethnicity on hypertension, independent of other factors that vary with ethnicity, are poorly understood. We examined the prevalence of hypertension (defined as systolic > or =140 or diastolic > or =90 mm Hg or receiving treatment), treatment, and control (to <140/<90 mm Hg) in a multiethnic study of premenopausal and perimenopausal women. Stepwise multivariable logistic regression was used to select covariates associated with hypertension. Among 3292 women, 46.9% were white, 28.3% were black, 8.7% were Hispanic, 7.6% were Chinese, and 8.5% were Japanese. Among these 5 ethnic groups, respectively, there was substantial variation in prevalence of normal blood pressure levels (<120/<80 mm Hg; 59.9%, 35.4%, 16.8%, 67.2%, and 63.7%) and hypertension (14.5%, 38.1%, 27.6%, 12.8%, and 11.0%). After multivariable adjustment, hypertension prevalence was 2 to 3x higher among black and Hispanic women but similar among Chinese and Japanese women compared with white women. Among hypertensive participants, prevalence of antihypertensive treatment was highest among blacks (58.9%) and whites (55.2%) and lowest among Chinese (34.4%). Prevalence of control to goal blood pressure levels was highest among whites (43.0%) and Japanese (38.7%) and markedly lower among Hispanic women (11.4%). Compared with whites, black and Hispanic women have significantly higher prevalence of hypertension independent of other factors, whereas Chinese and Japanese women have similar prevalence. Treatment and control rates vary considerably across ethnicities. Greater efforts must be made to improve hypertension awareness, treatment, and control in all middle-aged women, particularly those in ethnic minority groups.

摘要

关于美国女性某些种族群体中高血压患病率、治疗情况及控制率的数据较为稀少。此外,种族对高血压的影响,独立于其他随种族而变化的因素,目前了解甚少。我们在一项针对绝经前和围绝经期女性的多民族研究中,考察了高血压(定义为收缩压≥140或舒张压≥90毫米汞柱或正在接受治疗)的患病率、治疗情况及控制情况(控制到<140/<90毫米汞柱)。采用逐步多变量逻辑回归来选择与高血压相关的协变量。在3292名女性中,46.9%为白人,28.3%为黑人,8.7%为西班牙裔,7.6%为华裔,8.5%为日裔。在这5个种族群体中,正常血压水平(<120/<80毫米汞柱;分别为59.9%、35.4%、16.8%、67.2%和63.7%)和高血压(分别为14.5%、38.1%、27.6%、12.8%和11.0%)的患病率存在显著差异。经过多变量调整后,与白人女性相比,黑人和西班牙裔女性的高血压患病率高出2至3倍,但华裔和日裔女性的患病率与之相似。在高血压患者中,抗高血压治疗的患病率在黑人(58.9%)和白人(55.2%)中最高,而在华裔中最低(34.4%)。血压控制到目标水平的患病率在白人(43.0%)和日裔(38.7%)中最高,而在西班牙裔女性中明显较低(11.4%)。与白人相比,黑人和西班牙裔女性独立于其他因素的高血压患病率显著更高,而华裔和日裔女性的患病率相似。不同种族的治疗率和控制率差异很大。必须做出更大努力,以提高所有中年女性,特别是少数族裔女性对高血压的认识、治疗和控制水平。

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